Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN070432 AP05045 | LA |
NPI | 1013099829 |
---|---|
Provider Name | Donna L Courson |
First Address | Monroe, LA 71201-8548 |
Second Address | Monroe, LA 71201-8548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 16/08/2019 |